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Fetal Heart Rate Monitoring Based on Adaptive Noise Cancellation and Maternal
QRS Removal Window
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M. Sheikh M. Algunaidi
Student Member IEEE Department of Electrical, Electronic & Systems Engineering
Faculty of Engineering and Built
Environment, University Kebangsaan Malaysia (UKM), Bangi, Malaysia
E-mail: malgun@vlsi.eng.ukm.my
M. A. Mohd Ali
Member IEEE, Department of Electrical, Electronic & Systems Engineering
Faculty of Engineering and Built
Environment, University Kebangsaan Malaysia (UKM, Bangi, Malaysia
E-mail: mama@vlsi.eng.ukm.my
K. B. Gan
Member IEEE, Department of Electrical, Electronic & Systems Engineering
Faculty of Engineering and Built
Environment, University Kebangsaan Malaysia (UKM), Bangi, Malaysia
E. Zahedi
Member IEEE, School of Electrical Engineering, SHARIF University of Technology
Tehran, Iran
Abstract
In this paper a new method to extract the fetal signal from the abdominal
electrocardiogram (ECG) is presented. A three-stage method for fetal heart rate detection
from abdominal ECG recordings is proposed. After preprocessing, adaptive noise
cancellation (ANC) is used to extract the fetal ECG. Then in the third stage maternal QRS
complex removal window is applied to eliminate or scale down the maternal residual peaks.
The method is validated using 30 recorded data and compared with another three stage
method using independent component analysis (ICA) for the fetal ECG extraction. The
average sensitivity and average positive predictivity of the ANC based method is 85.8 %
and 67.6 % respectivly compared to 74.4% and 64.1% of the ICA based method. These
show that the ANC based method was more successful in detecting the FHR than ICA.
Keywords: Adaptive noise canceller, independent component analysis, fetal heart rate
monitoring and QRS Removal Window.
Fetal Heart Rate Monitoring Based on Adaptive Noise Cancellation and Maternal
QRS Removal Window 566
1. Introduction
Fetal heart rate (FHR) monitoring is one of the methodologies to test fetal well being and diagnose for
possible abnormalities. Fetal monitoring throughout the pregnancy enables the clinician to diagnose
and recognize the pathologic condition especially asphyxia [1].
Although Doppler ultrasound device is currently used for FHR monitoring, it is not suitable for
long term monitoring due to its sensitivity to movement and its safety for long term exposure has yet to
be established [2]. Besides ultrasound, non-invasive electrocardiography has been used to obtain
valuable clinical information about the fetal well being during pregnancy. The extraction of the fetal
electrocardiogram (ECG) can be carried out via skin electrodes attached to the maternal abdomen.
However, the abdominal ECG (AECG) is always corrupted with power line interference, maternal
ECG (MECG) and electromyogram where its variability is influenced by the gestational age, position
of the electrodes and the skin impedance [3]. Therefore, appropriate signal processing techniques are
required to reveal the fetal ECG (FECG) from the AECG.
Various research efforts have been proposed to extract the FECG from the AECG such as
adaptive filtering [4], correlation techniques [5], blind source separation [6] and a combination of
wavelet analysis and blind source separation methods [7]. FHR can be calculated by determining the
R-R intervals from the extracted FECG. However, the extracted FECG is still corrupted by the residual
peaks of MECG (especially its QRS complexes) hence the FECG detection remains difficult.
In this paper, an adaptive noise canceller (ANC) is proposed to extract the FECG from the
AECG. A QRS removal window (a window for removing the maternal QRS (MQRS) complex),
algorithm is developed to eliminate the MECG residual peaks in the extracted FECG. The performance
of the proposed algorithm is evaluated and compared with the well-known independent component
analysis (ICA) algorithm by using recorded data from the Universiti Kebangsaan Malaysia Medical
Center (PPUKM).
2. Methodology
2.1. Data Acquisition
AECG signals were recorded from 30 healthy pregnant women (at 35 to 38 weeks of gestation), most
of which are corrupted with different levels of noises, using the lead system as shown in Fig. 1. The
experimental protocol was approved by the PPUKM Research and Ethical Committee prior to
commencement of the study and informed consents were obtained from all subjects.
com
P1 BIOPAC- MP
100A PC
P2
p4
P5
P3
The AECG signals, X(n) = [ X 1 (n ), X 2 (n ),..., X p (n )]T where n denotes a discrete-time index,
and T is the transpose operator, were simultaneously recorded from maternal abdomen using six
567 M. Sheikh M. Algunaidi, M. A. Mohd Ali, K. B. Gan and E. Zahedi
electrodes (five electrodes, p∈ [l, 2, 3, 4, 5], with a single common) using high gain amplifiers
(BIOPAC- MP 100A). The AECG signals were digitized at 1000 Hz with 12 bit resolution. The total
recording time during each session was about one minute.
Electrode p1 is located in such a way that only MECG signals are acquired while the electrodes
p2, p3, p4 and p5 acquired the mixture of MECG and FECG. Therefore, X 1 (n ) is defined as the
reference input and X 2 (n ) and X 3 (n ) are the primary input signals to the adaptive filter. As for ICA,
four of the acquired AECG signals, X(n) = [ X 2 (n ), X 3 (n ),..., X p (n )] p∈ [2, 3, 4, 5], are fed into the ICA
algorithm as X 1 (n ) contains only MECG signal
2.2. Algorithms
The block diagram of the proposed algorithm is shown in Figure (2). It consists of the pre-processing
stage, FECG extraction using ANC or ICA and the MQRS removal window.
Pre-processing functions
MQRS Removal
FECG SIGNAL
(a)
(b)
MECG p
X p = MECG p + FECG p
p∈ [2,3]
e
FECG p + +
y
MECG1 ≅ X 1 Adaptive filter
The noise MECG1 is filtered to produce an output y that is as close a replica as possible of
MECG p . This output is subtracted from the primary input X p to produce the system output
e = MECG p + FECG p − y (2)
Where y is the output of the adaptive filter Squaring both sides of Equation 2, we obtain
e 2 = FECG p2 + ( MECG p − y ) 2 + 2 FECG p ( MECG p − y ) (3)
Applying expectations on both sides of Equation 3, we get
569 M. Sheikh M. Algunaidi, M. A. Mohd Ali, K. B. Gan and E. Zahedi
i=0
h=∞
i = i+1
h=i
X1(i)> X1 (i ± 1)
yes
no
no X1(i-s) = 0
i>h
yes
no yes
i > h + 2s
(a)
(b)
2.3. Evaluation
The proposed algorithms have been implemented in Matlab codes using Matlab-7.4 (The Math-works
Inc.). The performances of the algorithms were then evaluated based on their sensitivities and positive
predictivities [15], when applied to AECG signal acquired from the PPUKM. The sensitivity is the
fraction of real events that are correctly detected and it is defined by,
TP
Se = (9)
TP + FN
The Positive Predictivity is the fraction of detections that are real events and it is defined by,
TP
+P= (10)
TP + FP
where FN (False Negatives) denotes the number of missed detections, FP (False Positives)
represents the number of extra detections and TP (True Positives) is the number of correctly detected
QRS complexes.
Figure 7: (a) Extracted FECG using ANC, (b) MQRS and (c) FECG signal after applying MQRS removal
window.
(a)
(b)
(c)
With this improvement on the extracted signal, the performance of the FECG extraction
techniques (ANC and ICA) is compared in terms of FHR detection. The FHR is calculated from the
RR interval after peak detection [16].
ANC method
ICA method
Weeks No Signals X2 as primary signal X3 as primary signal
Se (%) + P (%) Se (%) + P (%) Se (%) + P (%)
35 2 79.0 54.5 77.5 53.1 66.6 48.8
36 13 88.4 77.8 86.2 70.4 74.8 72.2
37 6 91.1 68.9 78.4 67.9 79.9 70.1
38 9 84.8 69.6 87.9 75.5 76.4 65.4
85.5(%) 67.6(%) 82.5(%) 66.7(%) 74.4(%) 64.1(%)
Fetal Heart Rate Monitoring Based on Adaptive Noise Cancellation and Maternal
QRS Removal Window 574
With the availability of the multi-lead system for the ICA used in this work, it is possible to
evaluate the lead position for the primary signal of the ANC that gives optimum results. Hence a
comparison is made between X 3 as the primary signal and X 2 as also shown in Table 1.
The average sensitivity of the proposed algorithm from the primary signal X 2 is 85.8 % as
compared to 82.5 % with primary signal X 3 . Also the average positive predictivity of the proposed
algorithm is 67.6% with primary signal X 2 as compared to X 3 with 66.7%.
The performance of the algorithm was better than ICA for both locations, although electrode
location p2 (associated with X2) is better than p3. This shows that the location of the electrode plays an
important role in FHR detection.
4. Conclusion
The proposed algorithm (ANC with the QRS Removal Window) has been demonstrated to have better
performance to extract the fetal signal. This method can use only two leads and a common. By using
the MQRS removal window it is shown that it is possible to control the amplitude of the maternal QRS
complex in the extracted signal or eliminate it. This facilitates detection of the fetal peaks and therefore
the determination of FHR.
The limitation of the proposed algorithm is that only signals which acquired later than 35
gestation weeks are tested. Farther improvement is required to implement the algorithm on ECG signal
earlier than 35 gestation week.
Current work is in progress towards realizing an online FHR detection using 24 bit high
resolution multi-channel bio-amplifier and finally the proposed algorithm will be fully tested in the
clinical environment.
Acknowledgement
The authors would like to thank the Ministry of Science, Technology and Innovation, Malaysia; for
supporting this work under the Science Fund Grant 03-01-02-SF0255.
The authors would like also to express their gratitude to Dr. Farshid Soheili for providing the
clinical data for this paper and especially Professor Dr. Muhamad Abdul Jamil M. Yassin and
Associate Professor Dr. Shuhaila Ahmad for their assistance in collecting the clinical data.
575 M. Sheikh M. Algunaidi, M. A. Mohd Ali, K. B. Gan and E. Zahedi
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